[Large-diameter balloon dilation in the treatment of esophageal achalasia].

OBJECTIVE

To evaluate the effectiveness and method of the large-diameter balloon dilation in the treatment of esophageal achalasia.

METHODS

The hydrophilic guide wire and Wilson-Cook's Savary-Gilliard dilators were inserted into the stomach through the oral cavity under fluoroscopy. The Boston's balloon (35 mm in diameter) was introduced to the stricture site at the cardia through the guide wire and was inflated by the pressure pump (maximum pressure 15 PSI) with the method of "graded intermittent inflation". The balloon was inflated again to the maximum diameter for 3-5 times with the maximum of 8 times.

RESULTS

The insertion of the Savary-Gilliard dilators and the Boston's balloon were technically successful in all the 204 patients. The cardia regions of the esophagus was ruptured and cured with conservative treatment in 2 patients. The follow-up time was 1-38 months (mean 18.5 months). Recurrent stenosis did not occur in any patient. The remission rate of dysphagia was 100%. The swallowing function was absolutely normal in 152 of the 204 patients (74.5%).

CONCLUSION

The Boston's balloon dilatation is simple and effective in the treatment of esophageal achalasia. It is considered to be an alternative to surgical procedures.